Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia
Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia
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DOI：
10.1002/uog.6234
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发表时间：
2008-11-01
影响因子：
7.1
通讯作者：
Deprest, J.
中科院分区：
文献类型：
--
作者：
Jani, J.;Cannie, M.;Deprest, J.
目的探讨磁共振成像（MRI）测量胎儿肺总体积（TFLV）对先天性膈疝（CDH）的预测价值。方法对22-38孕周的先天性膈疝（CDH）胎儿行MRI检查，测量TFLV，评估腹腔脏器疝，妊娠30周后活产，并接受产后随访直至死亡或出院。采用回归分析研究诊断时胎龄、观察到的预期（o/e）TFLV、胸内肝疝、CDH侧、分娩时胎龄对生存率的影响。在76例胎儿中，在2周内测量o/e TFLV和肺面积与头围比（LHR）;结果在符合入选标准的148例病例中，多因素回归分析显示，有无胸内肝疝和O/e TFLV。o/eTFLV预测出生后存活率的受试者工作特征曲线下面积为0.786（标准误0.059; P < 0.001），o/eLHR预测出生后存活率的受试者工作特征曲线下面积为0.743（标准误0.069; P = 0.001）。结论在CDH胎儿的评估中，MRI为基础的o/eTFLV可用于预测出生后存活率。Copyright（c）2008 ISUOG.出版社：John Wiley & Sons，Ltd
Objectives To investigate the potential value of antenatally determined total fetal lung volume (TFLV) by magnetic resonance imaging (MRI) in the prediction of the postnatal survival in congenital diaphragmatic hernia (CDH).Methods We examined fetuses with isolated CDH, in which MRI was used at 22-38 weeks of gestation to measure TFLV and assess intrathoracic herniation of abdominal viscera, that were liveborn after 30 weeks of gestation and had postnatal follow-up until death or discharge from hospital. Regression analysis was used to investigate the effect on survival of gestational age at diagnosis, observed to expected (o/e) TFLV, intrathoracic herniation of the liver, side of CDH, gestational age at delivery. In 76 fetuses measurements of o/e TFLV and the lung area to head circumference ratio (LHR) were performed within 2 weeks of each other; in these cases o/e TFLV and o/e LHR were compared for their prediction of postnatal survival.Results In the 148 cases that fulfilled the entry criteria, multiple regression analysis demonstrated that significant predictors of survival were the presence or absence of intrathoracic herniation of the liver and o/e TFLV. The area under the receiver-operating characteristics curves for prediction of postnatal survival from o/e TFLV was 0.786 (standard error, 0.059; P < 0.001) and that from o/e LHR was 0.743 (standard error, 0.069; P = 0.001).Conclusions In the assessment of of fetuses with CDH, MRI-based o/e TFLV is useful in the prediction of postnatal survival. Copyright (c) 2008 ISUOG. Published by John Wiley & Sons, Ltd.